Manubrial-clavicular-chest wall explantation to expose the anterior thoracic inlet.

The anterior thoracic inlet is difficult to access surgically because of the overlying pectoral-shoulder girdle, clavicle, and manubrium. With both the Dartevelle and Grunenwald approaches, retraction of an osteomuscular flap is required, and patients may be left with the functional and aesthetic implications of partial clavicular resection. We describe a novel technique involving manubrial-clavicular-chest wall explantation with preservation and reimplantation. Manubrial and clavicular plating is performed to stabilize the anterior chest wall and clavicle after reimplantation. This approach represents an alternative technique that provides excellent visualization of the entire anterior thoracic inlet.